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NPI Code Detail

MEDICARE: MRS. CECILIA A VERZOSA PT

MEDICARE: MRS. CECILIA A VERZOSA PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2169TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710963061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CECILIA A VERZOSA PT
Provider Business Mailing Address
First Line : 325 W MORRIS BLVD
Second Line :
City : MORRISTOWN
State : TN
Zip : 37813-2237
Country : US
Telephone Number : 423-375-8907
Fax Number : 423-822-5514
Provider Business Practice Location Address
First Line : 900 W MAIN ST
Second Line :
City : ROGERSVILLE
State : TN
Zip : 37857-2448
Country : US
Telephone Number : 423-500-5600
Fax Number : 423-317-7773
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 10/15/2024

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